Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
Hepatobiliary Pancreat Dis Int. 2024 Oct;23(5):481-486. doi: 10.1016/j.hbpd.2023.01.002. Epub 2023 Jan 14.
Cavernous transformation of the portal vein (CTPV) due to portal vein obstruction is a rare vascular anomaly defined as the formation of multiple collateral vessels in the hepatic hilum. This study aimed to investigate the imaging features of intrahepatic portal vein in adult patients with CTPV and establish the relationship between the manifestations of intrahepatic portal vein and the progression of CTPV.
We retrospectively analyzed 14 CTPV patients in Beijing Tsinghua Changgung Hospital. All patients underwent both direct portal venography (DPV) and computed tomography angiography (CTA) to reveal the manifestations of the portal venous system. The vessels measured included the left portal vein (LPV), right portal vein (RPV), main portal vein (MPV) and the portal vein bifurcation (PVB).
Nine males and 5 females, with a median age of 40.5 years, were included in the study. No significant difference was found in the diameters of the LPV or RPV measured by DPV and CTA. The visualization in terms of LPV, RPV and PVB measured by DPV was higher than that by CTA. There was a significant association between LPV/RPV and PVB/MPV in term of visibility revealed with DPV (P = 0.01), while this association was not observed with CTA. According to the imaging features of the portal vein measured by DPV, CTPV was classified into three categories to facilitate the diagnosis and treatment.
DPV was more accurate than CTA for revealing the course of the intrahepatic portal vein in patients with CTPV. The classification of CTPV, that originated from the imaging features of the portal vein revealed by DPV, may provide a new perspective for the diagnosis and treatment of CTPV.
门静脉海绵样变性（CTPV）是由于门静脉阻塞导致的罕见血管异常，定义为肝门部形成多个侧支血管。本研究旨在探讨成人 CTPV 患者肝内门静脉的影像学特征，并建立肝内门静脉表现与 CTPV 进展之间的关系。
我们回顾性分析了北京清华长庚医院的 14 例 CTPV 患者。所有患者均行直接门静脉造影（DPV）和计算机断层血管造影（CTA）以显示门静脉系统的表现。测量的血管包括左门静脉（LPV）、右门静脉（RPV）、主门静脉（MPV）和门静脉分叉（PVB）。
本研究纳入 9 名男性和 5 名女性，中位年龄为 40.5 岁。DPV 和 CTA 测量的 LPV 或 RPV 直径无显著差异。DPV 测量的 LPV、RPV 和 PVB 的显示率明显高于 CTA。DPV 显示的 LPV/RPV 与 PVB/MPV 之间存在显著相关性（P = 0.01），而 CTA 则无此相关性。根据 DPV 测量的门静脉影像学特征，将 CTPV 分为三类，以利于诊断和治疗。
DPV 比 CTA 更能准确显示 CTPV 患者肝内门静脉的走行。基于 DPV 显示的门静脉影像学特征对 CTPV 的分类，可能为 CTPV 的诊断和治疗提供新的视角。
